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. 2022 Jan-Feb;44(1):35-40.
doi: 10.1590/1516-4446-2021-1747.

Evening chronotype as a bipolar feature among patients with major depressive disorder: the results of a pilot factor analysis

Lukasz Mokros  1 , Katarzyna Nowakowska-Domagała  2 , Andrzej Witusik  3 , Tadeusz Pietras  4
Affiliations

Evening chronotype as a bipolar feature among patients with major depressive disorder: the results of a pilot factor analysis

Lukasz Mokros et al. Braz J Psychiatry. 2022 Jan-Feb.

Abstract

Objectives: The bipolar spectrum concept has resulted in a paradigm shift that has affected both the diagnosis and therapy of mood disorders, with bipolarity becoming an indicator of treatment resistance in depression. Evening circadian preference has also been linked to affective disorders. The aim of our study was to confirm the relationship between the severity of depressive symptoms, bipolar features, chronotype, and sleep quality among patients with major depressive disorder.

Methods: A group of 55 individuals who were recruited from a mental health outpatient clinic completed the following psychometric tools: a Chronotype Questionnaire comprising morningness-eveningness (ME) and subjective amplitude of the rhythm (AM) scales, the Hypomania Checklist 32 (HCL-32), the Beck Depression Inventory (BDI) and the Pittsburgh Sleep Quality Index (PSQI).

Results: Factor analysis identified two latent components, accounting cumulatively for 58% of variables: depressive symptoms (BDI and PSQI) and bipolarity (ME, AM, and HCL-32). After rotation, ME loading in the first factor increased the result to a significant level. The correlation between the two components was very low.

Conclusions: Evening chronotype appears to be a bipolarity-related marker, with this relationship being independent of its link to depressive symptoms and sleep quality. Eveningness and high circadian rhythm amplitude may offer promise as diagnostic, prognostic, and therapeutic predictors.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1. Flowchart showing patient selection for the MDD group. MDD = major depressive disorder.
Figure 2
Figure 2. Graphic illustration of the paths elucidated between measured and latent traits in the factor analysis of the relationship between ME, AM, BDI, HCL-32, and PSQI scores in major depressive disorder patients. AM = subjective amplitude of the rhythm; BDI = Beck Depression Inventory; HCL-32 = Hypomania Checklist 32; ME = morningness-eveningness; PSQI = Pittsburgh Sleep Quality Index.
See this image and copyright information in PMC

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